CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(10): E1293-E1300
DOI: 10.1055/a-0970-9005
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Intraductal temperature-controlled radiofrequency ablation in malignant hilar obstruction: a preliminary study in animals and initial human experience

Eui Joo Kim
1  Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
,
Jae Hee Cho
1  Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
,
Yoon Jae Kim
1  Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
,
Tae Hoon Lee
2  Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea
,
Joon Mee Kim
3  Department of Pathology, Inha University School of Medicine, Incheon, Republic of Korea
,
Seok Jeong
4  Department of Gastroenterology and Hepatology, and the National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Inha University School of Medicine, Incheon, Republic of Korea
,
Yeon Suk Kim
1  Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon, Republic of Korea
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 16. Januar 2019

accepted after revision 22. Mai 2019

Publikationsdatum:
07. Oktober 2019 (online)

  

Abstract

Background and study aims Intraductal radiofrequency ablation (ID-RFA) is a recently developed method widely used for treatment of malignant extrahepatic biliary tract obstructions. However, its safety in hilar application has yet to be clearly demonstrated. The aim of this study was to evaluate the safety of ID-RFA in the treatment of malignant hilar obstruction.

Patients and methods Endoscopic retrograde cholangiography followed by temperature-controlled ID-RFA at the hilar area using different probe lengths (11, 18, and 22 mm) and settings (7 or 10 W for 60 – 120 s) was performed in six mini-pigs. In addition, patients with malignant hilar obstruction who underwent palliative ID-RFA were retrospectively evaluated.

Results In the animal study using different ID-RFA settings, post-ID-RFA fluoroscopic radiocontrast leakage and microscopic bile duct perforation with hepatic abscess were observed in four of the six mini-pigs. Only two of the them, in which an 11-mm ID-RFA probe at a target temperature of 80 °C, power of 7 W, and duration of 60 s was used, underwent successful ID-RFA without any immediate adverse events (AEs). Clinically, ID-RFA was performed using the 11-mm probe with the setting of 80 °C, 7 W, and 60 – 120 s for malignant hilar obstruction, and total of 11 patients underwent successful ID-RFA without AEs.

Conclusions Our study suggests that ID-RFA performed using a short-length probe with settings of 80 °C, 7 W and 60 – 120 s is a safe and feasible palliative treatment for malignant hilar obstruction.